Dental surgey to DO or NOT to do... in a senior

[theHuman]

Hi all, my girl [Apple] is about to turn 12 (in December) and she is going in for xrays and ultra sound tomorrow. She has the 'high numbers' for kidney problems.  On her last check up, few weeks ago we noticed the 2 molars ( i think M1) are chipped. One is showing the root and the other is not so bad.

My question is, can this teeth work be done at this age?  I have always been worried about Greyhound surgery complications !

Also, if her kidneys are really bad, is it proper to put her through a surgery?   

Apple's diet is Forza10 Renal food, but eats very little of it, and also has fresh fish and turkey soup daily. Few drops of Milk Thistle.  Anyone have great results with any other food or supplements?

[macoduck]

Is your vet really greyhound-savvy? That may be most important thing.

Do you and your vet have Amicar (aminocaproic acid) or Tranexamic Acid on hand? Your vet may have the Amicar as a stock item in injectible form. The TA I purchased at the Walmart pharmacy with a prescription from my vet. Much cheaper than the Amicar. The TA would be an off-label use of a med usually given to women for heavy menstrual bleeding.

I mention these because my 12 year old greyhound started throwing clots and bleeding heavily post-op while still with my vet. He'd had several extractions. Long story but I already had both meds on hand *just in case* and was so glad I did. Percy recovered and lived another year. Even a dog who is not a know bleeder still might bleed. I had that happen with another senior within seconds of having an implant inserted. Massive bleeding on the floor of the vet office but it didn't phase him one bit.

Your vet would be a better judge of how this might affect the kidneys. IIRC, there may be more monitoring and fluids provided than usual.

Reference site greyhound blood values:   www.greythealth.com and the www.GreyhoundHealthInitiative.org

[greysmom]

How bad her kidney issues are will be the determining factor.  If her values aren't super high then a dental will likely help her.  Poor dental hygiene can contribute to all sorts of health issues.  We just had one of our girl's first to molars on either side removed due to the same issues and she's been so much happier since then.  She's 9 years old and fairly sensitive to anesthesia issues, but it needed to be done.  Imagine having a whole root of a major tooth exposed like that and trying to eat!

Have a really indepth conversation with your vet about his anesthesia protocol, and his other safety precautions for post dental monitoring, pushing fluids, and keeping their vitamin K levels steady.  And having Amicar on hand just in case.

[Remolacha]

I did a dental on Conner when he was 12, but his kidney values were fine. I still took the precaution to take him to a specialty dentist where they had an anesthesiologist to monitor him during the surgery, separate from the vet doing the actual dental. He had several extractions, but was just fine after. It was a lot more expensive, but totally worth it. As Chris said, how bad her kidneys are should be the deciding factor, and if you do go ahead, consider a specialty dentist.

[MP_the4pack]

CC was in renal failure when she had a dental. But we knew her severe mouth would only accelerate her kidney disease. So she had a dental when I first got her; lost 24 teeth.  While she was only 5 at that time her kidneys were already shot. 

She survived and will have gotten close to 2 more years out of those kidneys. 

I also had a 15 year old go through a dental.  I went to an expensive dentist and she came through just fine.

[cleptogrey]

I wouldn't.  Kidney challenged? Felix  had gorgeous choppers until his kidneys started to fail. I would  not chance taxing any of his systems.

my addisonian scottie had rotting molars due to the disease and meds. My vet gave him a sedative and was able to gently pull the rotted molars. 

That's how I deal with physically challenged dogs who had bad teeth in their later years.

[MaryJane]

Excessive bleeding from the extractions and hyper-temperature coming out of anesthesia are issues that greyhounds can face.  A vet experienced with greyhounds is a must but even then, problems can happen especially with kidney problems. You might want to wait a few months and see whether the teeth are impacting her quality of life. 

[theHuman]

Hi everyone and Thank you all for the great input!  As mentioned, Apple went in for her 100 point check up   , This  included xrays, utltrasound, blood work, urinalysis (cath), T4 thyroid.  The vet said late stage 3 or early 4 kidney disease.  So the dental work is pushed back.

Obviously we are quite emotional here but need to work through this.  I've read that  high kidney numbers can possibly be from other issues and if this is the case would like some advice on some of the issues they found on her ultrasound.

Quote :  " 1. increase density in cranial abdomen,  2. prominent spleen, 3. this gastric wall - there is a mild thickening of the gastric fundic wall measuring 1.4-1.9 cm. This could be benign ulcerative gastritis or onset of gastric neoplasia.  

Both kidneys appear normal but bot adrenal glands are moderate and enlarged. The spleen is prominent but no masses. Liver and pancreas are normal.  Final impression: Gastric Fundic thickening could be benign ulcerative gastritis, Bilateral adrenonmegally suggest cushings "

 

Is it possible the gatric wall issue can be causing the high blood numbers and SDMA?  

here are the numbers:  SDMA 31, CREA 455, UREA 46, PHOS 2.95, CI 129, T4 12, MCV 77.9, MCH 26.7, RETIC-HGB 30.6,  Rbc 7.5, hct 58.4,  Bun/crea 25

low numbers: WBC 4.76,  lym 0.5 , EOS 0,02

Urinalysis - spec gravity 1.020 , These are check box values ;  leuokocytes = 0  , nitrate = Neg, Robilinogen =3.2, Protein 1.0, ph 6.5, Blood 25, ketone = Neg, Billirubin =Neg, Glucose =Neg

Meds given:  Epakitin for kidney , and IB-zyme for stomach.  IV for while at the vet

Since the vet visit she has eaten her fish and turkey soup meals but is not drinking much. Can the meds work that fast?  She has been losing weight over the past few weeks.  Note that her brother passed a few weeks ago who was 13  

 

 

[theHuman]

... Additional Question and my current thinking is heal the gastric wall ?!!!  Has anyone seen a 'thick gastric wall' and what did you do?

[SerenityHounds]

Completely agree with Macoduck. Have the Amicar on hand ( you can order it from Roadrunner Pharmacy in Phoenix, AZ), not at all expensive from them. It is normally started 3 days before and goes 3 days after. 

And also have, or ask the Vet if they have Yunnan Baiyao on hand. I also had an older greyhound who went into uncontrolled bleeding from a dental, one molar extractions, and bled for 10 hours. Had two blood transfusions. The Emergency Vet used Yunnan Baiyao, and I had the Amicart. She said they did not know how or why it worked, but it is an ancient Chinese blood treatment. It will coagulate the blood. She said they keep it on hand all the time. They did an extraordinary job in saving his life that night.

Google "Yunnan Baiyao in Dogs", Greyhound Bleeding, and get the two items to keep on hand. Both are in my canine emergency kit. My Eastern/Western Vet keeps the Yunnan Baiyao, and now Amicar on hand. I buy the YB online.

https://bestchinesemedicines.com/products/yunnan-baiyao-capsules-jiaonang/

Good luck. We are our pets advocates. 

[cleptogrey]

it sounds as if you are ready to go for it. just wait a tad to make sure her meds for cushings are on target. my late scottie had addison's disease- the complete opposite- but also an auto immune disease (often cushings patients turn into addisonians).  keeping his meds balanced was a challenge, but i did it for 10 years! the stress of going under might throw things off. good luck w/ your pup.

[theHuman]

6 hours ago, cleptogrey said:

it sounds as if you are ready to go for it. just wait a tad to make sure her meds for cushings are on target. my late scottie had addison's disease- the complete opposite- but also an auto immune disease (often cushings patients turn into addisonians).  keeping his meds balanced was a challenge, but i did it for 10 years! the stress of going under might throw things off. good luck w/ your pup.

Hi cleptogrey, actually i am not going ahead with the dentistry and pushing it back.  Her kidney numbers are crazy and the gastric wall issue is of BIG concern. My vet is not a "greyhound" vet per say, so i feel like i'm at a disadvantage. 

[cleptogrey]

49 minutes ago, theHuman said:

Hi cleptogrey, actually i am not going ahead with the dentistry and pushing it back.  Her kidney numbers are crazy and the gastric wall issue is of BIG concern. My vet is not a "greyhound" vet per say, so i feel like i'm at a disadvantage. 

your vet need not to be a GH person. vets can easily look up info, it's at their fingertips. in my opinion your vet is steering you in the correct direction. let her enjoy life with out anything physically taxing. it's quality of life at her age- yeah the breath....i know....but kidney breath is absolutely the worst! 

[pppittpeter]

I'm sending positive vibes to Apple. It's tough seeing our fur babies go through health stuff, especially as they get older.

[Ilaria]

On 11/20/2020 at 7:17 PM, theHuman said:

Hi everyone and Thank you all for the great input!  As mentioned, Apple went in for her 100 point check up   , This  included xrays, utltrasound, blood work, urinalysis (cath), T4 thyroid.  The vet said late stage 3 or early 4 kidney disease.  So the dental work is pushed back.

Obviously we are quite emotional here but need to work through this.  I've read that  high kidney numbers can possibly be from other issues and if this is the case would like some advice on some of the issues they found on her ultrasound.

Quote :  " 1. increase density in cranial abdomen,  2. prominent spleen, 3. this gastric wall - there is a mild thickening of the gastric fundic wall measuring 1.4-1.9 cm. This could be benign ulcerative gastritis or onset of gastric neoplasia.  

Both kidneys appear normal but bot adrenal glands are moderate and enlarged. The spleen is prominent but no masses. Liver and pancreas are normal.  Final impression: Gastric Fundic thickening could be benign ulcerative gastritis, Bilateral adrenonmegally suggest cushings "

 

Is it possible the gatric wall issue can be causing the high blood numbers and SDMA?  

here are the numbers:  SDMA 31, CREA 455, UREA 46, PHOS 2.95, CI 129, T4 12, MCV 77.9, MCH 26.7, RETIC-HGB 30.6,  Rbc 7.5, hct 58.4,  Bun/crea 25

low numbers: WBC 4.76,  lym 0.5 , EOS 0,02

Urinalysis - spec gravity 1.020 , These are check box values ;  leuokocytes = 0  , nitrate = Neg, Robilinogen =3.2, Protein 1.0, ph 6.5, Blood 25, ketone = Neg, Billirubin =Neg, Glucose =Neg

Meds given:  Epakitin for kidney , and IB-zyme for stomach.  IV for while at the vet

Since the vet visit she has eaten her fish and turkey soup meals but is not drinking much. Can the meds work that fast?  She has been losing weight over the past few weeks.  Note that her brother passed a few weeks ago who was 13  

 

 

Did they test her for Cushing? It can lead to a quantity of symptoms (I'm not really aware about Cushing in dogs but I have a Cushing horse and he has a number of problems). About her not drinking it is normal because they pushed fluids while in their care, she should go back to normal drinking the next day.

Hugs to your sweet Apple

[macoduck]

1 hour ago, Ilaria said:

Did they test her for Cushing? It can lead to a quantity of symptoms (I'm not really aware about Cushing in dogs but I have a Cushing horse and he has a number of problems). About her not drinking it is normal because they pushed fluids while in their care, she should go back to normal drinking the next day.

Hugs to your sweet Apple

The original post is 3 years old and they haven't looked at any replies since November 2020.

[pppittpeter]

On 2/16/2024 at 4:11 PM, pppittpeter said:

I'm sending positive vibes to Apple. It's tough seeing our fur babies go through health stuff, especially as they get older.

As for the dental surgery dilemma, I totally get your concerns about complications, especially with senior pups. It might be worth reaching out to a trusted vet or even a cosmetic dentist in Eastlake Ohio for some expert advice. They could give you some insights on whether the surgery would be safe for Apple, given her kidney issues.
In the meantime, it sounds like you're doing an awesome job with her diet and supplements. Keep up the good work, and hopefully, you'll find a solution that works best for Apple's health and happiness!